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Yet a robust science base exists on social, biological, and environmental factors that influence young people to use tobacco, the physiology of progression from experimentation to addiction, other health effects of tobacco use, the epidemiology of youth and young adult tobacco use, and evidence-based interventions that have proven effective at reducing both initiation and prevalence of tobacco use among young people

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Not everyone with a genetic profile associated with RA will develop the disease, and while not all environmental factors are known, smoking tobacco has been consistently identified as a major contributor to the risk of developing RA that is associated with elevated levels of anticyclic citrullinated peptide (anti-CCP), which in turn is associated with more aggressive disease and severe joint erosion (5)